Hair-raising questions

A leading dermatologist addresses a few follicular-oriented queries.

By Anna Gamboa Gan

MAY 2013

In a society that values voluminous, lustrous locks, consumers are eager to find the latest cure for an itchy scalp or excessive hair fall. Some are even willing to spend hefty amounts on creative treatment methods like “water acupuncture” and “infrared scalp therapy.” A lot of hair concerns are actual medical problems, though.

The roots of the problem

Peachy Paz-Lao, M.D., chairman of the Department of Dermatology at Makati Medical Center and the head of the MCF DermLaser and Phototherapy Center, has seen more than her fair share of hair and scalp problems in patients. The most common hair and scalp complaints she encounters are “thinning hair, falling hair, alopecia, patients whose scalps are showing, too much hair on the pillow in the morning, dandruff and psoriasis.”

“Hair loss is caused by a lot of things, it cannot be caused by one factor,” says Dr. Paz-Lao, “It can start from … genetics, [hormones], from an imbalance in your body minerals, to specific conditions, to diet, everything—you can’t just point [at] one thing that can cause hair loss.”

“There are diseases of the scalp, and the scalp is different from the hair. If there’s something wrong with the scalp, there’s possibly something wrong with the hair. … Alopecia is different from shedding, [it] means there are areas in your scalp where there’s no hair,” she clarifies. “Shedding is a diffuse loss of hair, and there are a lot of factors which can lead to this. When you arrest the medical condition that [causes shedding], then you can [stop it],” the dermatologist explains.

“With psoriasis, which is genetic, we see patients with very thick scales on the scalp,” explains the dermatologist. “We can minimize and control, but we cannot totally eradicate it. It’s actually a difficult case to handle because [the condition is for life].”

“We also see people who pull their hair, or break their hair,” she adds. “For me, you have to go to the root of the problem, and then you can attack the cause. What’s often difficult is identifying the particular disease [causing the problem].”

Let down your hair…

Dr. Paz-Lao further explains that hair fall, especially in females, is normal, as part of a cyclical shedding cycle. “We lose about a hundred strands a day. Why? Our hair population is composed of three phases … telogen, anagen and catagen,” she says.

Normally, majority of the hair on our heads at any given time is in the growing phase or anagen, which lasts for two to six years. During this time, hair cells are actively dividing at the root. Then, during the two or three weeks of catagen or the transitional phase, growth halts and the hair follicle shrinks in diameter. Telogen is the resting phase, when the hair follicle is not active at all, forming “club hair,” which is eventually pushed out when new hair replaces it during the next anagen phase. About 25 to 100 telogen hairs are shed daily.

“[In the case of post-partum shedding], pregnant women will notice that after they give birth, a lot of their hair falls off. This is hormonal. … Some pregnant women will even say that during their nine months, their hair become more lavish and thick—it’s because of the hormones. And when you give birth these hormones also go out of your system, and that drastic change from high hormonal content to almost zero content would loosen up the stability of the hair,” she elaborates. This phenomenon stops when hormone levels finally stabilize. If hair fall continues long after giving birth, a medical professional should look into the matter.

While on the subject of hormones, the dermatologist also adds that hyperthyroidism is also another possible contributing factor for hair fall. Another cause: your diet, or what you may not be ingesting. “If your protein or albumin content in your body drops, your hair will fall. Hair is made of protein, so you need protein,” explains the doctor. Iron or magnesium deficiency is another cause for abnormal hair fall—but Dr. Paz-Lao assures that once the cause is pinpointed and corrected, this can prevent further shedding.

Stress and hair ironing also have a lot to do with hair problems. Learn more do’s and don’ts when it comes to hair care from Dr. Paz-Lao in the May issue of HealthToday.

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